The effectiveness of medications for PTSD in general has been well studied, but the effectiveness of medicatio.ns prescribed specifically for post-traumatic stress disorder (PTSD) nightmares is less well known. This retrospective chart review examined the efficacy of various medications used in actual treatment of PTSD nightmares at one Veteran Affairs Hospital. Records at the Salem, VA Veterans Affairs Medical Center (VAMC) were examined from 2009 to 2013 to check for the efficacy of actual treatments used in comparis.on with treatments suggested in three main review articles. The final sample consisted of 327 patients and 478 separate medication trials involving 21 individual medications plus 13 different medication combinations. The three most frequently utilized medications were prazosin (107 trials), risperidone (81 trials), and quetiapine (72 trials). Five medications had 20 or more trials with successful results (partial to full nightmare cessation) in >50% of trials: risperidone (77%, 1.0–6.0 mg), clonidine (63%, 0.1–2.0 mg), quetiapine (50%, 12.5–800.0 mg), mirtazapine (50%; 7.5–30.0 mg), and terazosin (64%, 50.0–300.0 mg). Notably, olanzapine (2.5–10.0) was successful (full remission) in all five prescription trials in five separate patients. Based on the clinical results, the use of risperidone, clonidine, terazosin, and olanzapine warrants additional investigation in clinically controlled trials as medications prescribed specifically for PTSD nightmares.

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This paper focuses on the concept of the "intentional arc" in Merleau-Ponty, who maintains that perception comes into play within, and is nourished by, an already established relation between the person and the world. That obscure relation, the intentional arc, is the "genesis" of perception, and this paper argues that in it resides the proper theme of a psychological phenomenology of perception. A study of the intentional arc shows that perception is not a passive, causal, impersonal process. On the contrary, perception is active in that it requires the perceiver's free consent to the solicitations stemming from the world; it is thus only motivated or beckoned, but not caused; and it rests on a personal foundation, which is to say that it depends on the entire psychological life of the perceiver. A subsequent paper will enrich and develop the implications of this thesis by taking up the phenomenology of hallucinations.